Lena Nicodemus, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

101557 Issued in CA

Practice address

1080 Stanford Ave
20
Oakland, CA 94608-2350

Phone

(443) 253-2178

NPI assigned

Nov 13, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Brittany Nicodemus Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1457725418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 STANFORD AVE",
            "address_2": "#20",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 STANFORD AVE",
            "address_2": "20",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082350",
            "telephone_number": "443-253-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "LENA",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lena@irisdbt.com",
            "affiliation": "N",
            "address_1": "2811 Castro Valley Blvd Ste 208",
            "city": "Castro Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945465562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "NICODEMUS",
            "credential": "MA, LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Czar Nicholas
• D. Jeanette Nichols
• Scott Lee Nickell, MSN, FNP
• Esther Yoon Nickelson, FNP-C
• John Thomas Nickens, PHD
• Natasha L Nicolai, DPT
• Arrian Tolentino Nicolas
• Heidi Gayle Nicoll-Merson, MD
• Anna S Nidhiry, DO
• Niekia M. Franklin, DDS, MSD, Inc.

• Marriage & Family Therapist in Oakland, CA
• Providers in Oakland, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.